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Monday, January 30, 2006

Why That Career?

There are a couple of interesting health care articles in the papers today, that made me wonder why certain people would get into the health care professions.

The first, four pharmacists in Illinois are suing Walgreens for firing them. They claim they were released, in violation of the Illinois Health Care Right of Conscience Act, because they wouldn't sign pledges to dispense the "morning after" birth control pill.

I'm generally not a supporter of that drug, but I do wonder why you would get into a profession that you know will require you to dispense things you have a moral problem with? Illinois and Wisconsin have been centers of a battle over pharmacists rights to refuse to dispense drugs they have "moral objections" too.

The second article discusses broader measures to protect health care workers in general from having to treat patients or provide treatments that go against their personal beliefs. I have a major problem with this. Who protects patients? What happens to the guy or gal in the Webmiztris' home town of Bumfuck, Pa. when the only two doctors on call decide they don't "personally believe in _______ (place lifestyle choice, etc here)" but a patient who fits that criteria comes into the emergency room?

I'm all for personal choice, and not being forced into doing something that you find morally questionable. At the same time, you should be personally responsible enough to know that certain professions would probably require you to get in those situations, and avoid those professions.

It's not just medical professionals. There have been a number of cases in the last few years of Military Chaplains wanting to preach consciencious objection to the troops, because that is what their religion says. Well wait a minute, why would you chose the military (and probably take ROTC money to get your degree) if you don't believe in what they do?

So, if you are reading this and are young enough to be picking a career, pick one that won't require you to make moral choices you don't like or one where those choices can be made without affecting others.

12Comments:

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I work in a hospital (currently in registration, doing data analysis, but previously did 10 years on inpatient psych). People get into healthcare because they want to help people. If you start subjecting them routinely to procedures, etc. that clearly violate their consciences, you're going to lose practically everybody who cares enough to do this sort of work--then where will you be? At some point, the moral preferences of the workers themselves have to be given consideration. I'm not saying I'm necessarily for any particular legislated solution, but the fact remains: force healthcare workers to go against their consciences often enough, you'll have a "healthcare crisis" beyond your comprenhension. No doctors, no nurses, no nursing assistants.

On a related note, I saw an article on my local birdcage liner's website (see here), about a supposed "groundswell" of support for nationalized health insurance. Talk about chaos--practially every problem with healthcare today can be traced directly to government regulation of/intervention into healthcare. This type of crap just drives me up a wall. The numbers routinely cited for the number of Americans "without health insurance" is made up almost entirely (estimates I've seen typically run around 80-90%) of people who are only temporarily without insurance. And of those who are more permanently without, a signifant portion are voluntarily so (small businesses, self-employed, etc.). And the myth that people don't have access to healthcare: spend a Friday night in any big city hospital's ER, and you'll see a flood of people who "don't have access to healthcare" getting some of the best healthcare in the world, without paying for it. Because, that small minority who don't have insurance--and supposedly "don't have access"--routinely over-utilize ERs far out of proportion to those who do have insurance.

The "morning after pill" was probably not thought of when these pharmacists began their career.

I work in healthcare and have loved doing so. I often work with hospice and end of life care. With the Supreme Court's ruling on "assisted suicide", I may have to make some of these decisions of my own.

Pharmicy is not a very short path to follow to have a career. From the information I had gotten from the pharmacists at the Drug Store I had worked at, they may have more education that lawyers (not surprising, I know). The "morning after" pill has not been around for a very long time, and available in the U.S. for much less. I'm guessing a lot of the pharmicists that might have an objection to dispensing the "morning after" pill had at least started down that career path long before they thought they'd have to worry about dispensing that pill.

As for an emergency D&C, I bet there are very few health care practitioners who would equate that to an abortion, certainly not "abortion on demand" that most people find objectionable. There may still be a few, and I would hope that all of them would not mingle in the same geographical area I guess.

jgf- while the 'morning after' pill wasn't around, this actually was aroused originally in Wisconsin and Illinois by pharmacists who refused to fill regular birth control prescriptions based on religious beliefs, and then refused to transfer them either.

jgf and Jeff, I go back to my belief. If you are in a profession that requires you as a regular course of the job to do something you can't do because of your beliefs, then it's probably time for a new profession.

While I don't think it's generally a big deal in major metro areas, passing laws such as are being proposed would be a major crisis in very rural areas, where "other providers" are not just around the corner.

At the very least, any practitioner that has these doubts needs to let every patient know about them as soon as they show up in their office, not when it suddenly becomes an issue. It'll probably cost some business in the short run, and save a lot of grief in the long one.

Every Career has a potential to fall outside ones moral ethics. I come from multiple generations of book binders and none of us will bind Porno or Cannabis books. Someone somewhere will do it but not I.

Just because opposition is a possibility in most every job does not mean one should avoid it.

Your statements have far to broad a stroke. Perhaps managing people to allow for these variations would be an alternative. Your suggestion that someone out in nowheres-ville may not receive medical care because they fall outside the moral parameters of the provider is rather absurd. My Spouse is a medical provider and deals with the immediate health need first as any good provider would. Questions of choice such as the morning after pill are not life saving medical care.

Crazy, I agree--but again I'll reiterate: if employers in healthcare push too hard against the moral beliefs of their employees, they'll lose those employees. And that could mean hospitals run by--nobody.

ablur - While I agree the ma pill isn't "live saving care", check out the article and look at some of the stuff some states are talking of letting providers "opt out" of performing, and some of the language.

Do you let your clients know up front what you will and won't do printing and binding on? Should a doctor do the same?

Jeff- I agree there could be some issues, mostly in specialty practices and in hospital priveledges for some doctors at some hospitals.

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"War is an ugly thing, but not the ugliest of things. The decayed and degraded state of moral and patriotic feeling which thinks nothing is worth war is much worse. A man who has nothing for which he is willing to fight, nothing he cares about more than his own personal safety, is a miserable creature who can never be free except made and kept so by the exertions of better men than himself." --John Stuart Mill